Disability from endometriosis in the United States Army.

The impact of endometriosis on the general population has been well documented, and the prevalence rate is quoted as 10%. The records of 6,456 women in the United States Army were reviewed with respect to age, race and active duty status. The active duty records were further evaluated for total sick days from endometriosis-related problems. This evaluation revealed a mean sick time of 15 days per admission per active-duty patient regardless of age or race. The estimate of lost duty time was 21,746 days, considering all active-duty patients in the study (five years of records). The prevalence of endometriosis in the female U.S. Army population was 6.2%. Diagnosis and treatment of endometriosis should be aggressively pursued whenever the disease is suspected.

Atrial fibrillation during a subarachnoid block in a patient with undiagnosed mitral valve prolapse.

Mitral valve prolapse (MVP) is a common cardiac abnormality, and there are numerous documented cases of intraoperative dysrhythmias. However, the authors describe what is believed to be the first case of atrial fibrillation in a patient with an undiagnosed MVP who was given a subarachnoid block. A possible clinical sequencing for the subarachnoid block is offered. The differential diagnosis, etiology, pathology, and pathophysiology of MVP are discussed. Also detailed are the management of intraoperative dysrhythmias. Physicians should be aware, as in the case reported, that a new-onset atrial fibrillation can occur, even without previously diagnosed MVP.